Barefoot for back pain: Dr. Rangan Chatterjee's 4 Pillar Plan

The BBC's "Doctor in the House" Dr. Rangan Chatterjee has been barefoot for 7 years. He came to VIVO on the recommendation of a friend, whilst in search of a way to remedy chronic back pain - and found that barefoot was just what the Doctor ordered.

Rangan advocates that 'Lifestyle Medicine' in the form of healthy dailychanges could revolutionise modern healthcare, advocating its impact on chronic issues from depression to diabetes. He recently made the public recommendation that all children should be given the choice to squat or use a standing desk in school.

In his new Best Selling book 'The 4 Pillar Plan: How to Relax, Eat, Move and Sleep Your Way to a Longer, Healthier Life' Rangan explores how "Our modern lifestyles make it hard for our bodies to move in the way they are designed to" and offers a series of insights into re-awakening natural, healthy behaviours and enjoying all the wellbeing benefits this can unlock.

Here, we share an excerpt for giving a new lease of life to your glutes - so often tense and inflexible from the habits of sedentary modern lifestyles.

MOVE 5: WAKE UP YOUR SLEEPY GLUTES

EXTEND, EXTEND, EXTEND

This has been my mantra for the past few years and I hope it will become yours as well! We need to re-teach our body to extend. People struggle to extend their hips, people struggle to extend their spines. Of course, sitting less is extremely helpful but it doesn’t automatically allow our bodies to experience extension. Most of us will need help in order to access our body’s powers of extension in full.

When people are working on their bodies today, they tend to focus too much on the ‘mirror muscles’, which are the ones you can see in the mirror and so, naturally, the ones they prefer to work on. They get caught up in exercises that make the mirror muscles look good, such as bench presses, bicep curls and sit-ups. All these exercises ask the body to flex. We need more focus on the muscles we can’t see in the mirror, such as the ones on our back that extend the body and make it stand up straight.

As a teenager, a classic tall, skinny Indian kid, I remember being in the changing room at school and I could see my ribs. This made me extremely self-conscious. Meanwhile, I was being exposed to pictures of buff men in all the fitness magazines. I started doing chest presses and sit-ups every day. I kept this up for about two years and yes, I put on muscle. But I also inadvertently changed all of my body movement mechanics. Was it worth it? Absolutely not. I had to spend years in pain and then years of corrective exercises to undo the damage I’d caused. My mistake was being motivated purely by vanity and focusing on the mirror muscles. I see this whenever I’m in a gym – bodybuilders with overflexed and hunched shoulders, flat feet and rounded spines clearly walking around with poor posture and limited mobility.

I’ve always prided myself on being particularly open minded as a doctor and I’m always enthusiastic about learning about new things from different healthcare professionals. I was actually the first medical doctor to study with Gary, and what blew my mind about him was the fact he saw the body in exactly the same way that I saw health. He was motivated by desire to understand the root cause of problems, rather than simply suppress bodily symptoms. When I came to him with my back problem he very quickly identified that my right foot was ‘stuck’ in pronation. In other words, my foot arch had effectively collapsed and my foot was flat and so unable to access its opposite posture. Podiatrists had told me about my flat foot before but simply prescribed orthotic insoles, which hadn’t worked.

Gary had a different solution. He told me he needed to get my right foot working again, insisting that was the key to my back problems. But you might be thinking, what has this got to do with glutes? Well, in our massively connected bodies, there’s actually a strong link between our foot muscles and our glute muscles. If one of our feet isn’t working properly this can directly affect our glutes, and vice versa. It turned out that my right glute muscle wasn’t switching on and this meant my back was always going to struggle. My back was taking the strain instead of my sleepy backside.

Under Gary’s guidance, it soon became clear why none of those, from physiotherapists to masseurs, who’d been manipulating my back over the years had solved the problem. They’d only been offering a temporary sticking-plaster fix. To completely heal my back, Gary had to teach me to reprogramme these damaging patterns and re-educate my body. I had to get my feet working correctly again. This, in turn, would reawaken my glute muscles. Incredibly, with just five minutes if exercise per day, over the course of less than a week, my longstanding back problems vanished. My exercises were based largely on the four I have detailed at the end of this section. It was the nearest thing to a miracle I’ve ever witnessed. Now, a few years on, I have a natural right-foot arch, my right glute is firing appropriately and my back pain has never resurfaced.

It was in Gary’s brilliant book What the Foot? And on his training courses that I first learned about the importance of glutes, and how we must reawaken them in order to combat the effects of our flexed, hunched-over lifestyles. The glutes are extensor chain muscles. They aid the extension of the hip, which is the motion we make when standing up or coming out of a squat (as opposed to the flexion we make when bending at the hip to sit down). Hip extension and glute contraction should happen together. But in our super-flexed world, we’re missing the ability to extend our hips properly. I want you to learn how to move your whole body to access hip extension using the following four exercises. I believe that these exercises will give your body the opportunity to awaken your glutes for evermore.

Some of you might have been through the rigmarole of extending your hips after many a physio session and you might even have come to the conclusion that it doesn’t work. If so, I suspect, your discomforts have continued. But this is where Gary’s unique philosophy kicks in. He believes that we’ve become flexed to such an extent that when we even try to extend, using the traditional exercises, we slip into bad habits. Our bodies have simply forgotten how to move as they should. Whenever we stand up, we’re supposed to be using our glutes. Most of us don’t. Our brains bypass the glutes, using other muscles. In order to retrain the brain, Gary has created a series of exercises that invite it to fire the right muscles. The important thing to know is that we can’t simply consciously ‘decide’ to use our glutes and therefore extend properly. Our brains make these decisions for us, unconsciously. Therefore, we need exercises that remind the brain how to trigger the correct muscles. And this is exactly what Gary has designed. Here’s just one example. By bending the hip fully, we create a situation in which the only movement left available is one of proper extension. When we lie on our front and lift one of our legs, we should be doing it using our glute. But when instructed to do this, our brain has many options. Because our glutes are switched off, it tends to choose easier ones. Gary’s movements make it so the brain has no option but to lift the leg in the proper way, using the glute.

Gary and I have come up with four movements that are designed to get your feet moving, your hips extending and your glutes firing. They’ll help to retrain your brain to operate your body in accordance with the way it was designed. They can be carried out individually or as part of a group.

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